+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement

Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement

Journal of Medical Internet Research 20(12): E10273

Health literacy research seems to lack a consensus on what aspects to include into literacy in the context of health and on how to operationalize these concepts for measurement purposes. In addition to health literacy, several other concepts, such as electronic health (eHealth) literacy and mental health literacy, have been developed across disciplines. This study examines how these different concepts are used when studying health-related competencies in Web contexts. This study systematically reviews health literacy concepts and definitions and their operationalization in studies focused on Web-based health information environments. A systematic literature search was conducted in April 2016 in 6 electronic databases with a limitation to articles in English published between January 2011 and April 2016. Altogether, 1289 unique records were identified and screened according to the predefined inclusion criteria: (1) original, peer-reviewed research articles written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of the study was placed on an Web-based information environment. In total, 180 full texts were screened, of which 68 were included in the review. The studies were analyzed with an emphasis on the used health literacy concepts and measures. On the basis of the included studies, several concepts are in use when studying health-related literacy in Web environments, eHealth literacy and health literacy being the most common ones. The reviewed studies represent a variety of disciplines, but mostly medical sciences. Typically, quantitative research methods are used. On the basis of the definitions for health literacy, 3 thematic categories were identified: general and skill-based, multidimensional, and domain-specific health literacy. Most studies adopted a domain-specific concept, followed by the ones that used a general and skill-based concept. Multidimensional concepts occurred least frequently. The general health literacy concepts were usually operationalized with reading comprehension measures, the domain-specific concepts with self-efficacy measures, and multidimensional concepts with several types of measures. However, inconsistencies in operationalization were identified. The results show that in studies conducted in Web-based information environments, several different health literacy concepts are in use, and there is no clear consensus on the definitions for these concepts. Future studies should place emphasis on the conceptual development of health literacy in Web contexts to gain better results on operationalization for measurement. Researchers are encouraged to provide clear operational definitions for the concepts they use to ensure transparency in reporting.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 066022859

Download citation: RISBibTeXText

PMID: 30567690

Related references

Health literacy and public health: a systematic review and integration of definitions and models. Bmc Public Health 12: 80, 2012

Health literacy in childhood and youth: a systematic review of definitions and models. Bmc Public Health 17(1): 361, 2017

Low health literacy and evaluation of online health information: a systematic review of the literature. Journal of Medical Internet Research 17(5): E112, 2015

Do Web-based Mental Health Literacy Interventions Improve the Mental Health Literacy of Adult Consumers? Results From a Systematic Review. Journal of Medical Internet Research 18(6): E165, 2016

Cognitive factors of using health apps: systematic analysis of relationships among health consciousness, health information orientation, eHealth literacy, and health app use efficacy. Journal of Medical Internet Research 16(5): E125, 2014

Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. Computers in Human Behavior 69: 256-267, 2017

Definitions and measurement of chronic health conditions in childhood: a systematic review. JAMA 297(24): 2741-2751, 2007

Optimal health literacy measurement for the clinical setting: A systematic review. Patient Education and Counseling 98(11): 1295-1307, 2015

Measurement of health literacy in patients with cardiovascular diseases: A systematic review. Research in Social and Administrative Pharmacy 15(12): 1395-1405, 2019

Correlation Between eHealth Literacy and Health Literacy Using the eHealth Literacy Scale and Real-Life Experiences in the Health Sector as a Proxy Measure of Functional Health Literacy: Cross-Sectional Web-Based Survey. Journal of Medical Internet Research 20(10): E281, 2018

Health literacy in Italy: a cross-sectional study protocol to assess the health literacy level in a population-based sample, and to validate health literacy measures in the Italian language. Bmj Open 7(11): E017812, 2017

Self-administered health literacy instruments for people with diabetes: systematic review of measurement properties. Journal of Advanced Nursing 73(9): 2035-2048, 2017

Measurement properties of mental health literacy tools measuring help-seeking: a systematic review. Journal of Mental Health 26(6): 543-555, 2017

Generic health literacy measurement instruments for children and adolescents: a systematic review of the literature. Bmc Public Health 18(1): 166, 2018

Effectiveness of information and communication technologies interventions to increase mental health literacy: A systematic review. Early Intervention in Psychiatry 12(6): 1024-1037, 2018